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Table 3 Cumulative Dose-Related Reduction in Fracture Risk Achieved by Steroid-Dependent Asthmatic Adults after Substituting ICS for Past Prednisone Therapy

From: Asthma and Therapeutics: Inhaled Corticosteroids, Corticosteroid Osteoporosis, and the Risk of Fracture in Chronic Asthma

  Percent of Group with Normal Bone Density*  
Cumulative Lifetime ICS Exposure Men (n = 26) Women (n = 43)
(10.1 ± 5.5 yr) Age 58.5 ± 17.6 (SD) yr Age 60.8 ± 9.6 (SD) yr
≤3 g 20 50
>3 g 40§ 65§
  1. Adapted from Toogood JH et al. [4]
  2. ICS = inhaled corticosteroid.
  3. *Lumbosacral bone mineral density Z-score (LBMD-Z): +4 to -1.
  4. All postmenopausal women received supplemental estrogen.
  5. Median lifetime cumulative ICS exposure = 3 g. Lifetime prednisone exposures were balanced equally between the higher and lower lifetime ICS exposure subgroups (p = .87) [4].
  6. §Larger lifetime exposures to ICS were associated with more normal LBMD-Z scores (p = .002 analysis of covariance) and a substantially larger number of patients with Z-scores indicating no increase in fracture risk [4].